The Oregon Legislature created the Oregon Medical Board in 1889 to regulate the practice of medicine in the state of Oregon and to protect Oregon citizens from unauthorized or unqualified persons. Lawmakers created the Board after 10 years of lobbying by the Oregon State Medical Society (now known as the Oregon Medical Association or OMA). The Legislature charged the new Board with enforcing the Oregon Medical Practice Act.1
That Act required the Governor to compose the first board of “three persons from among the most competent physicians of the state." Gov. Sylvester Pennoyer appointed James Brown, MD, James Dickson, MD, and O.P.S. Plummer, MD, as the first Board members (pictured).
To become licensed, a physician was required to show his or her diploma from a medical school or to pass a Board examination. A “grandfather" clause in the Board creation bill allowed practitioners already in the state to become licensed by signing their county registry of physicians and surgeons within 60 days of the bill's passage into law.
The Legislature strengthened the Medical Practice Act in 1895. Board membership was expanded to include five representatives: “(T)hree regulars, one eclectic and one homeopathic." All applicants for a medical license were required to submit data on their educational backgrounds and pass an examination covering all branches of medicine. Physicians who were licensed under the old law were again exempted from the new regulations.
For the first time, the law defined unprofessional conduct. Unethical behavior included the “employment of cappers or steerers (payment of a patient for a testimonial), moral turpitude, betraying professional secrets and obtaining a fee for the care of an incurable disease."
The next significant change came in 1907, when the Legislature extended the Board's responsibilities to include regulation of osteopathic medicine and physicians. Lawmakers also added an osteopathic physician to the Board, increasing the size of the Board to six members.
In 1929, the Oregon State Medical Society circulated a statewide ballot initiative proposing that each applicant for a license in the healing arts be required to take and pass a uniform examination on their knowledge of the basic sciences. The test would be prepared and administered by a group of non-partisan educators from the state-accredited institutions of higher education. The new Basic Science Law would not affect persons already licensed. The Society's proposal failed to make the ballot, but the 1931 Legislature adopted a version of the initiative.
In 1941, Lorienne Conlee became the Board's first Executive Secretary, the position now known as Executive Director.
During the late 1940s, the Board began to place physicians on probation for violating the Medical Practice Act.
A physician shortage in the late 1960s prompted the Legislature to review licensure requirements. In 1973, lawmakers repealed the Basic Science Law because components of the examination had either been incorporated into other licensing examinations or become outdated.
1970-1999: The Board Grows in Numbers and in ScopeProfessional Groups
The physician shortage and other societal changes precipitated a major shift in the direction of the Board. In the 1970s, the Board took responsibility for five additional professional groups, modifying the traditional definition of the practice of medicine by physicians to include newly emerging groups of healthcare professionals.
The first group of new licensees to come under the Board's purview was physician assistants in 1971. Some had served as military paramedics in Vietnam. Others were nurses and long-time employees in physicians' offices.
In 1973, the Legislature added acupuncturists to the Board's regulatory responsibilities. The Acupuncture Advisory Committee met for the first time the following year. One of the original Committee members, Joel Seres, MD, of Portland, served for three decades before retiring in 2004.
Emergency Medical Services (EMS) providers came under Board supervision in 1975. The 1989 Legislature transferred much of that program to the Oregon Health Division (now Oregon Health Authority). However, the Board still has the responsibility for EMS provider scope of practice.2
The 1981 Legislature dissolved the 56-year-old State Board of Podiatry Examiners and placed its licensees under the Board's jurisdiction. By 1989, all statutory provisions governing podiatry had been transferred from their separate ORS chapter into the Medical Practice Act.
Nurse practitioners with prescription privileges were placed under Board authority in 1979, but removed to the Board of Nursing eight years later.
In 1991, lawmakers expanded the practice of optometry to include topical application of pharmaceutical agents to the eye for the purpose of diagnosis and treatment. The Board, with the advice and consent of the Board of Optometry, created a formulary of allowable topical agents for optometrists' use. Two years later, the Legislature reversed the order of responsibility for the optometric formulary. The Board of Optometry, with the advice and consent of the Oregon Medical Board, now designates the pharmaceutical agents for topical use by optometrists.
Also in 1991, the Board was given jurisdiction over Respiratory Care Practitioners (RCP). In 1997, the RCP program was transferred to Oregon Health Authority.Medical Practice Act
The Medical Practice Act was amended in 1975 to substantially increase the Board's powers in disciplinary matters. For example, it became possible to summarily suspend the license of a physician if he or she posed an immediate danger to the public. It also became possible for the Board to suspend or revoke a physician's license for failure to appear for an informal hearing with the Board.
The 1975 Legislature also approved a law assuring confidentiality for persons filing complaints against licensees. As a result, complaints increased dramatically, and their number continues to rise. That same year, lawmakers passed a mandatory reporting law, requiring physicians to report to the Board any actions by colleagues, which might raise questions regarding their ability to practice medicine. Insurance companies were also required to report any malpractice claim filed against a provider.
Two years later, the Legislature extended the mandatory reporting law to hospitals, which were required to report changes in privileges or any disciplinary actions taken against staff members. Insurance companies were required to report medical malpractice claims against Oregon physicians to the Board as well. Ultimately, the 2009 Legislature increased reporting requirements to all licensed healthcare providers. This includes nurses, dentists, pharmacists and chiropractors. Board Members and Staff
In 1979, the Legislature added a public member to the Board, bringing the total number of members to nine. Ten years later, lawmakers added a second public member and another physician (MD) member, enlarging the Board to an 11-member panel.
In 1986, the Board hired its first medical director, Donald Dobson, MD, an anesthesiologist from Portland.
Into the New Millennium
The Board continued to adapt to changing times and technologies. In 2001, the Board issued a formal Statement of Philosophy regarding the medical use of lasers. The Board declared the use of lasers and other, similar devices to be surgery, requiring appropriate training and supervision.
The 2003 Legislature made a number of changes in Oregon healthcare law, including changes in reporting requirements for individuals, hospitals and healthcare systems. The Medical Practice Act now specifies a period of 10 working days within which OMB licensees, healthcare facilities and certain professional associations (including the OMA) must report detrimental physician conduct to the OMB. Self-reporting of such conduct is also now required within 10 working days of the incident or event.
Also in 2003, the Legislature created a semi-independent Oregon Patient Safety Commission, which is charged with receiving reports and complaints about cases in which patient safety might be compromised or jeopardized. However, the law continues to give the OMB subpoena power, even if a case is reported to the commission.
Physician assistants that year were granted the privilege of prescribing and administering Schedule II controlled substances, after fulfilling specific educational and certification requirements.
Interest in professionalism and continuing competency increased among medical educators and regulators during this period. In January 2005, the Board held a full-day retreat to discuss these issues and the Board's role in furthering them. As a result, the Board adopted a Statement of Philosophy on Professionalism in May 2005.
In 2005, the Legislature gave the OMB authority to conduct fingerprint and national criminal record background checks on applicants for licensure.3
The 2006 Legislature added a podiatric physician to the Board as a 12th member and abolished the 24-year-old Advisory Council on Podiatry.4 The podiatric physician was originally barred by statute from voting on matters not concerning podiatry, but the 2007 Legislature overturned that prohibition effective January 1, 2008.
A New Name
Previously known as the Oregon Board of Medical Examiners, on January 1, 2008, the agency name changed to the Oregon Medical Board. The Board-requested name change5 reflects the fact that the Board no longer administers an examination to candidates for licensure. The new name also helps avoid confusion between the OMB and the Office of the State Medical Examiner.
A Dynamic Profession
The medical profession continues to evolve with new opportunities and challenges. The Board has addressed these developments in medicine with administrative rules and Statements of Philosophy. In 2011, House Bill 224 led to sweeping changes in physician assistant regulation. For the first time, physician assistant licensure was separated from the establishment of a supervisory relationship with a physician.
Also in 2011, the Board saw an increase in the number of healthcare professionals returning to practice after a period of clinical inactivity. To encourage re-entry into the healthcare workforce, a Statement of Philosophy on Re-Entry to Clinical Practice was adopted that year.
Statements of Philosophy on telemedicine (2012), the use of unlicensed healthcare personnel (2012) and pain management (2013) also gave providers guidance in rapidly changing areas of practice. In addition, a Statement of Philosophy on Cultural Competency was adopted in 2013 to address of the changing population of Oregon and healthcare consumers following the Affordable Care Act.
In October 2013, the Board amended its 2006 rules on office-based surgery to meet the need for additional regulation of the ever-increasing number and complexity of procedures being performed outside of licensed ambulatory surgery centers and hospitals.
2014: Celebrating 125 Years of Patient Safety
Now in its 125th year, the Board continues to regulate the practice of medicine in Oregon through licensing, education, investigation and discipline. Governor John Kitzhaber, MD, called the work done by the Board to protect the health, safety and wellbeing of Oregonians "inspiring" in his commemorative letter.
Today, the Board oversees nearly 20,000 professionals, including medical and osteopathic physicians, podiatric physicians, physician assistants and acupuncturists. The Board also maintains its responsibility for the scope of practice for Emergency Medical Services providers. The Board is privileged to work with Oregon's physicians, physician assistants and acupuncturists, who constitute one of the finest groups of healthcare professionals in the country.